Saturday, January 23, 2010

A very funny piece of satire posted by Adolf at No Minister reminded me of a few thoughts I had had regarding the Massachusetts victory (isn't it great how you can put in a few letters vaguely resembling the state name and the spell checker obliges?)

Was there ever a more glaring illustration of how politically ignorant most people are?

Barack Obama was voted in on a wave of feel-good romanticism. No doubt many felt bighearted and broad-minded simply by voting in the first black President. Did they care or know what Obama's politics were? I don't think so. It was symbolism and idealism all the way to the polls.

But how quickly his popularity has waned as his plans have actually permeated the almost-impenetrable political conciousness of many, thanks to a huge effort on behalf of those individuals and groups who have relentlessly written about, lobbied and rallied against Obamacare, which would represent a huge step towards what America has rejected since its constitution was written.

There is a lot wrong with the US but there is still an understanding of individual freedom simmering away. They have been through, and are still going through, very tough times. But out of adversity, good will often result. A reawakening of what their founding fathers believed in may be that good. I hope so.

Friday, January 22, 2010

Statistics released today by the Ministry of Social Development show that numbers on the sickness benefit have jumped by 8,000 or 16 percent in the past year. That is the largest yearly increase recorded since the sickness benefit became available in the 1930s.

Welfare commentator Lindsay Mitchell believes this is as much a reflection of the recession as an increasing incidence of sickness or accidents.

"Looking at the profile of people on the sickness benefit, compared to five years ago they are younger, fewer have worked in the past year and more have a psychological or psychiatric incapacity. Often depression and stress can relate to being unemployed."

"The government needs to take great care at this time not to let people who should be on an unemployment benefit migrate to one of the longer term benefits like sickness, invalid or domestic purposes benefits. As the economy recovers numbers on the unemployment benefit can be expected to fall. But people on other benefits have a much greater likelihood of becoming entrenched."

Another day of reading the news and shaking the head. Keys says if GST rises, so will benefits. That's only fair.

A wealth of research shows behavioural changes according to benefit payment rates. For example, the rate of single parenthood rises with an increase in the relevant benefit payment.

Do those people reacting to a higher benefit spend time analysing why the benefit payment has been increased? And if they did they would figure that benefits have increased relative to low wages. There is no mechanism for lifting low wages to compensate for increased GST (unless the government lifts the minimum wage but that hasn't been suggested - yet).

By the time the behavioural change is factored in, the extra revenue from increased GST (only $200 million after adjusting benefits, Working For Families and pensions) could disappear. If there was just a 3 percent rise in working age people claiming a benefit, the advantage would vanish. Any higher percentage growth and the government's position worsens.

This really is a pathetic government. Face facts Mr Key. We got by before WFF and all the other increased spending Labour introduced. We got by before the feminist, minority and human rights lobbies started using the benefit system to further their causes resulting in an explosion in welfare receipt. We need real tax reform and that can only happen with real spending reform. But you are not the man for that job.

Moreover, if you are talking about increasing WFF then you are, by your own previous definition, talking about increasing "communism by stealth."

Thursday, January 21, 2010

The state of Victoria has a higher population than NZ but fewer road fatalities. Last year they had a record low in road deaths.

But a terrible accident at the weekend killed five young people. Typical aspects all present. Young, male driver. Limited licence requirements flouted. High speed. Alcohol.

STEVEN Johnstone, the 19-year-old driver in Sunday's horror crash that claimed five young lives in Mill Park, makes a chilling case study on the limits of the law. The apprentice roof tiler had a speeding conviction in the past year and was only allowed to carry one passenger, according to police.

Instead, his car was crammed with six people as it slammed into an oak tree at 140 km/h after hurtling through the intersection of Childs and Plenty roads.

This is followed by a discussion of the limitations of the law, what has been tried so far and what direction the police may go in next.

The Deputy Police Commissioner was similarly unmoved by the call to destroy cars.

"I intuitively understand why people want to crush cars, but again I go back to the evidence that 99 per cent of people that lose their cars in the first instance don't reoffend."

(Cars can be impounded for up to 48 hours for a first speeding offence.)

The highly readable piece goes on to describe how there is a risk-taking type who shouldn't be behind the wheel and efforts to identify them are being stepped up. Academics are talking about brain scans. The police are talking about working more closely with health professionals and educationalists. The police have apparently "veered into the realm of psychology".

The thing is, even when you identify the 'type', how do you stop him from getting behind the wheel of a car, whether he owns it or not?

You would have more success trying to persuade other people not to get in a car with him. Ultimately, you cannot save people from themselves.

Air France-KLM is going to begin charging obese people 75 percent of the cost of buying a ticket for the adjacent seat. But I wonder how they are going to define obese? I think KLM is missing a more creative opportunity and solution. I am quite small and wouldn't mind doing a deal with a fattie. They can encroach on half of my seat if they pay half of my fare. It's a win-win. And I'd rather sit next to a fatty than someone who never shuts up.

So, Stuff tells us, 9 people have been on the unemployment benefit for more than 20 years. This unimpressive piece of trivia hides more than it reveals about the general degree of dependence on benefits. I believe the Ministry does not want that known because they have never conducted the research or supplied data in a form that would reveal its extent. But US and Australian research would indicate the level is likely to be high.

Looking at just the DPB for example 10,700 people have received that benefit continuously for 10 or more years; 15,800 have received that benefit or any other continuously for 10 or more years.

But many people have breaks off a benefit where they might work a period or form a relationship temporarily. They then drop out of the numbers that have been continuously on benefit. That doesn't mean their level of dependence is significantly less over a long period or over a lifetime. At June 2007 43,866 people on the DPB were reliant for a second (third, fourth etc) time. Many of them would not be featuring in the continuously dependent for 10 years or more despite having been cumulatively dependent for 10 or more years.

Bearing this significant short-coming in mind, across all benefits 37,300 people have been reliant continuously on their current benefit for 10 years or more; 62,000 have been reliant on their current or any other benefit for 10 years or more.

The highest rate of long-term dependence naturally features among invalid beneficiaries, but it is followed by the DPB. As partnered women with dependent children have higher employment rates than unpartnered, it is safe to conclude that single mothers are dependent on the state for longer than partnered women depend on their spouses or de factos.

It should be the other way around. But I see Paula Bennett is stalling again about introducing work-testing - the government is "still working on its welfare manifestos" - the very least National should be doing.

Tuesday, January 19, 2010

ACT has just issued a press release entitled; 'Three strikes' to become law.

ACT Leader Rodney Hide was today pleased to announce that ACT's 'Three Strikes' policy is to be incorporated into the Government's Sentencing and Parole Reform Bill for passing into law.

The deal that is acceptable to National seems well short of what ACT wanted.

David Garrett says;

"The key issues were the list of 'strike' offences, whether there should be a three or five year sentence to qualify for a 'strike' or just a conviction, and whether the 'Third Strike' would mean 'life' or the 'max',"

As the release reads, the sentence settled on to qualify the conviction as a 'strike' is 7 years.

And as far as I can ascertain the third strike simply delivers the maximum sentence without parole.

Apparently a new evaluation of the long-standing early education programme for low income children in the US has shown that there is very little difference in outcomes between those that are enrolled and those who were not. Rather than rely on the report about the report I had a very quick look at the actual evaluation;

In sum, this report finds that providing access to Head Start has benefits for both 3-year-olds and 4-year-olds in the cognitive, health, and parenting domains, and for 3-year-olds in the social-emotional domain. However, the benefits of access to Head Start at age four are largely absent by 1st grade for the program population as a whole. For 3-year-olds, there are few sustained benefits, although access to the program may lead to improved parent-child relationships through 1st grade, a potentially important finding for children’s longer term development.

Importantly this is an evaluation through to 1st grade only. A further report is pending into outcomes by 3rd grade.

Head Start has been going since 1965 and was instituted as part of Lyndon Johnson's War on Poverty.

It costs nearly $US7 billion and 60 percent of enrolled children are non-white.

I guess what interests me is other countries have modelled educational/social policies after Head Start. In NZ there has been increasing focus on and professionalisation of early education across the board. No doubt there will be many studies that show a positive effect. But when it comes to low income children in particular, I would think that the home environment and the parental input are more influential. Perhaps there is only so much intervention can (generally) achieve - and if this study is anything to go by - the difference may be disappointingly modest.

(Of course, it could also be argued that the quality of education and environment of Head Start needs to be extended through to later grades or that there is something wrong with US schools or that children are less malleable as they get older. I am beginning to wonder if I should even hit the publish button....but there isn't anything else that caught my interest today.)

Monday, January 18, 2010

Last year I wrote to each of the 21 DHBs and the Ministry of Health asking questions about the Methadone Programme under the Official Information Act. Over the years I have sent requests to various Ministries but none that I can recall to the Ministry of Health. The nature of the response itself was interesting.

A number of DHBs rang me obviously curious to know why I was curious to know. One woman was quite hostile, demanding indignantly, "Who are you?". An interested individual I answered. Another Doctor had a long conversation with me because, I think, he thought I was an ACT MP (this didn't become apparent until the end of our conversation or I would have put him right.) He was very forthcoming and told me how, for example, before they had been able to resolve waiting lists in his region, he believed women had deliberately become pregnant to get on the scheme. But the waiting lists were no longer a problem. Some areas however were still struggling because there was a shortage of or no pharmacies prepared to dispense to methadone patients.

Anyway it was quite clear that my request was provoking a mixed reaction. It must have been raised at a general MOH/DHB meeting and it was decided that the MOH would make a response on behalf of all DHBs. However, by this stage some of the DHBs had been good enough to compile an individual response. The variation between them, and the fact that the DHBs had no protocol for dealing with a request of this nature, is, as I said, interesting of itself.

For instance I asked how many patients had dependent children. All bar one response declined an answer citing either a lack of information or privacy. The DHB that did provide an answer said 85 percent of their methadone patients had dependent children.

I asked about the duration of stay on the methadone programme. The umbrella response from the MOH said that the information wasn't readily available "..but of those clients seen by methadone services in 2007/08, 3244 (81%) were seen for at least a year."

But I received more fulsome information from individual DHBs including;

The current average duration on the programme is 6 years which is the same as five years ago.

49.9 months currently and 28.5 months five years ago.

The average duration of patients on the programme is estimated at 5 years.

There are still some patients receiving the methadone since the programme started in ___ in 1995.

The MOH said they could not provide average duration. However when I asked how many people had used the programme since inception they answered that in the period 1 July 2001 to December 31 2008 the number was 8,887 nationally. As the number was 4,437 in 2007/08 a high turnover is not indicated. In fact in the calendar year 2008 517 people started on the programme and 300 left.

2 DHBs would only respond to certain questions if I paid. One estimated 40 hours at $76 per hour to answer 7 out of the 10 questions I asked. The other, 34 hours at $76 per hour. One said it would take 4 hours to calculate the cost of treating patients whereas all the other respondents, including the MOH, were able to provide an answer at no cost.

3 DHBs provided answers to 7-8 questions but they weren't necessarily the same ones. None of these mentioned charging.

All up there wasn't a single question that either one of the individual DHBs or the MOH didn't answer.

Which begs some questions; Why such a patchy response? Is information in certain areas only available to the wealthy? Isn't the OIA supposed guard against this very thing?

Some DHBs made a real attempt to supply the information. Others did not.

What did I learn?

*That, as I expected, the methadone programme is more about maintenance than rehabilitation. Of those who left the programme (300) 3 overdosed, 39 died, 39 left involuntarily and 219 left voluntarily. If we assumed that anyone who managed to wean themselves off methadone is in the 'voluntarily left' group, then the success rate in terms of rehabilitation is not high. 5% percent at the most.

*That if the one response I got regarding patients having dependent children is representative, the percentage is high.

*That the costs of administering the programme are climbing inexplicably. It rose by 52 percent between 2007/08 and 2001/02 whereas the numbers were relatively stable.

*That there is nothing remarkable about the ethnic make-up of patients which roughly matches the general population.

*That very few patients (1 percent) are under 20. Amazingly 17 are over 65.

If it was my call I would not dispense with the programme. It gives heroin addicts a chance to normalise (eg avoid crime, hold down a job, parent) or even recover. But the actual cost of methadone is next to nothing and some scrutiny into why it is costing $14 million to primarily maintain rather than cure addicts wouldn't go amiss. It's not unlike the welfare system really. Best of intentions gone awry. More dependence instead of less.

But I will conclude with my own bottom line in this area. If women are on the programme they should also have to use long-acting contraception as a condition of their admission. It could easily be administered as part of the clinic treatment. Babies being born addicts courtesy of the taxpayer weighs very heavily on my mind. There is an opportunity to discourage this from happening and strongly incentivise female addicts to get clean. It may be that some clinics already unofficially encourage female patients in this direction. I don't know.

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About Me

Lindsay Mitchell has been researching and commenting on welfare since 2001. Many of her articles have been published in mainstream media and she has appeared on radio,tv and before select committees discussing issues relating to welfare. Lindsay is also an artist who works under commission and exhibits at Wellington, New Zealand, galleries.